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Albania State Exam - Speech Therapist study materials
Albania State Exam - Speech Therapist study resources

Albania State Exam - Speech Therapist practice questions

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Question 1Anatomy and Physiology of the Speech, Language, and Hearing Systems

Which cranial nerve supplies the intrinsic muscles of the larynx and is therefore essential for phonation?

  1. The glossopharyngeal nerve (cranial nerve IX)
  2. The vagus nerve (cranial nerve X) Correct answer.
  3. The hypoglossal nerve (cranial nerve XII)
  4. The trigeminal nerve (cranial nerve V)

Explanation

The recurrent and superior laryngeal branches of the vagus nerve provide motor innervation to the laryngeal muscles that move the vocal folds. Without vagal supply the folds cannot adduct or tense for voicing. The hypoglossal nerve serves the tongue, the glossopharyngeal nerve is mainly sensory for the pharynx, and the trigeminal nerve is primarily sensory and masticatory.

Question 2Anatomy and Physiology of the Speech, Language, and Hearing Systems

The vocal folds (true vocal cords) are located at the level of which laryngeal structure?

  1. The cricoid cartilage Correct answer.
  2. The thyroid cartilage
  3. The vestibular folds
  4. The aryepiglottic fold

Explanation

The true vocal folds attach anteriorly to the thyroid cartilage and posteriorly to the arytenoid cartilages, sitting at the level of the cricoid ring. The cricoid provides the stable base on which the arytenoids pivot. The vestibular folds are the false cords above, and the aryepiglottic fold is part of the supraglottic inlet.

Question 3Anatomy and Physiology of the Speech, Language, and Hearing Systems

Which muscle is the primary abductor of the vocal folds, opening the glottis during inspiration?

  1. The lateral cricoarytenoid muscle
  2. The cricothyroid muscle
  3. The thyroarytenoid muscle
  4. The posterior cricoarytenoid muscle Correct answer.

Explanation

The posterior cricoarytenoid is the only intrinsic laryngeal muscle that rotates the arytenoids outward and widens the glottis. Its action is essential for airway protection during breathing. The lateral cricoarytenoid and thyroarytenoid are adductors, and the cricothyroid lengthens and tenses the folds.

Question 4Anatomy and Physiology of the Speech, Language, and Hearing Systems

Which structure separates the upper and lower respiratory tracts and is the site where the airway and food pathway cross?

  1. The nasopharynx
  2. The oropharynx
  3. The trachea
  4. The laryngopharynx Correct answer.

Explanation

The laryngopharynx (hypopharynx) lies below the epiglottis and communicates with both the larynx anteriorly and the esophagus posteriorly, making it the shared crossing point. The nasopharynx is above the soft palate, the oropharynx is behind the oral cavity, and the trachea begins below the larynx.

Question 5Anatomy and Physiology of the Speech, Language, and Hearing Systems

The soft palate elevates during swallowing primarily to perform which function?

  1. To seal the nasopharynx from the oropharynx Correct answer.
  2. To raise the hyoid bone
  3. To close the glottis
  4. To move the bolus into the esophagus

Explanation

Elevation of the soft palate, driven largely by the levator veli palatini, closes the velopharyngeal port so that food and liquid do not enter the nasal cavity. This velopharyngeal closure is a key protective event in the pharyngeal phase of swallowing. Glottic closure is a laryngeal event, esophageal transport follows pharyngeal contraction, and hyoid elevation is produced by the suprahyoid muscles.

Question 6Anatomy and Physiology of the Speech, Language, and Hearing Systems

Damage to the hypoglossal nerve would most directly impair which function?

  1. Vocal fold adduction
  2. Tongue movement Correct answer.
  3. Lip closure
  4. Jaw elevation

Explanation

The hypoglossal nerve (cranial nerve XII) is the motor nerve of all intrinsic and most extrinsic tongue muscles. Its damage causes weakness, deviation, and reduced articulation of lingual sounds. Lip closure is served by the facial nerve, jaw elevation by the trigeminal nerve, and vocal fold adduction by the vagus nerve.

Question 7Anatomy and Physiology of the Speech, Language, and Hearing Systems

Which cranial nerve provides motor supply to the muscles of facial expression, including the lips?

  1. The facial nerve Correct answer.
  2. The accessory nerve
  3. The glossopharyngeal nerve
  4. The trigeminal nerve

Explanation

The facial nerve (cranial nerve VII) innervates the muscles of facial expression, including the orbicularis oris, which is essential for lip rounding and closure in speech. The trigeminal nerve supplies the muscles of mastication, not expression. The glossopharyngeal nerve serves pharyngeal sensation and the accessory nerve supplies the sternocleidomastoid and trapezius.

Question 8Anatomy and Physiology of the Speech, Language, and Hearing Systems

The primary motor cortex that controls voluntary speech movements is located in which gyrus?

  1. The postcentral gyrus
  2. The cingulate gyrus
  3. The precentral gyrus Correct answer.
  4. The superior temporal gyrus

Explanation

The precentral gyrus of the frontal lobe houses the primary motor cortex, which sends descending motor commands for voluntary movement, including articulation. The postcentral gyrus is the primary somatosensory cortex, the superior temporal gyrus contains auditory association cortex, and the cingulate gyrus belongs to the limbic system.

Question 9Anatomy and Physiology of the Speech, Language, and Hearing Systems

Broca's area, important for speech production, is located in which lobe and hemisphere in most people?

  1. The left frontal lobe Correct answer.
  2. The right parietal lobe
  3. The right temporal lobe
  4. The left occipital lobe

Explanation

Broca's area lies in the posterior inferior frontal gyrus, usually of the left hemisphere, which is dominant for language in most individuals. It supports the programming and motor organization of speech. The temporal, parietal, and occipital regions listed do not correspond to this site.

Question 10Anatomy and Physiology of the Speech, Language, and Hearing Systems

Wernicke's area is most closely associated with which function?

  1. Motor execution of articulation
  2. Comprehension of spoken language Correct answer.
  3. Control of vocal fold vibration
  4. Regulation of breathing during speech

Explanation

Wernicke's area, in the posterior superior temporal gyrus of the dominant hemisphere, is critical for understanding spoken language. Damage produces fluent but meaningless speech with poor comprehension. Motor articulation is linked to Broca's area and the motor cortex, while vocal fold and respiratory control are subcortical and brainstem functions.

Question 11Anatomy and Physiology of the Speech, Language, and Hearing Systems

The arcuate fasciculus connects which two regions, and its damage classically produces conduction aphasia?

  1. The motor cortex and the spinal cord
  2. The occipital lobe and the temporal lobe
  3. The thalamus and the cerebellum
  4. Broca's area and Wernicke's area Correct answer.

Explanation

The arcuate fasciculus is a white matter tract linking the posterior language comprehension area with the anterior speech production area. Damage impairs repetition while relative comprehension and fluency are preserved, the pattern of conduction aphasia. The other pairs describe descending motor pathways or unrelated connections.

Question 12Anatomy and Physiology of the Speech, Language, and Hearing Systems

The cerebellum contributes to speech motor control primarily by performing which role?

  1. Coordinating timing and accuracy of articulatory movements Correct answer.
  2. Storing the meaning of words
  3. Generating the emotional prosody of speech
  4. Initiating voluntary vocal fold closure

Explanation

The cerebellum compares intended with actual motor output and adjusts timing, force, and coordination of ongoing movements, including articulation. Cerebellar damage produces ataxic dysarthria with irregular articulatory breakdowns. Emotional prosody is linked to limbic and right hemisphere circuits, word meaning to temporal language areas, and voluntary vocal fold closure to cortical and brainstem motor pathways.

Question 13Anatomy and Physiology of the Speech, Language, and Hearing Systems

The basal ganglia influence speech motor activity mainly through which mechanism?

  1. Modulation of cortical motor circuits via the thalamus Correct answer.
  2. Myelination of peripheral cranial nerves
  3. Direct sensory transduction of auditory input
  4. Production of cerebrospinal fluid

Explanation

The basal ganglia regulate movement by gating and scaling motor programs through thalamocortical loops. Dysfunction produces hypokinetic or hyperkinetic dysarthrias such as that in Parkinson's disease. They do not transduce sensory input, produce cerebrospinal fluid, or myelinate peripheral nerves.

Question 14Anatomy and Physiology of the Speech, Language, and Hearing Systems

Which brainstem structure contains the motor nuclei for most of the cranial nerves involved in speech?

  1. The corpus callosum
  2. The hypothalamus
  3. The hippocampus
  4. The medulla oblongata Correct answer.

Explanation

The medulla oblongata houses motor and sensory nuclei of several cranial nerves, including the hypoglossal nucleus, and contains centers for respiration and swallowing. These nuclei give the brainstem its role in reflexive and vegetative control of speech. The corpus callosum is a forebrain commissure, and the hypothalamus and hippocampus are diencephalic and limbic structures.

Question 15Anatomy and Physiology of the Speech, Language, and Hearing Systems

The auditory ossicles transmit sound vibrations from the tympanic membrane to which structure?

  1. The round window
  2. The eustachian tube
  3. The external auditory canal
  4. The oval window Correct answer.

Explanation

The malleus, incus, and stapes convey vibrations from the eardrum to the oval window at the base of the cochlea. This impedance-matching function amplifies sound for the fluid-filled inner ear. The round window is a pressure-release point, the eustachian tube equalizes middle ear pressure, and the external canal conducts sound to the eardrum.

Question 16Anatomy and Physiology of the Speech, Language, and Hearing Systems

The organ of Corti, which transduces sound into neural signals, is located within which structure?

  1. The vestibular sacs
  2. The tympanic cavity
  3. The cochlear duct Correct answer.
  4. The semicircular canals

Explanation

The organ of Corti sits on the basilar membrane within the cochlear duct of the inner ear and contains the hair cells that convert mechanical vibration into nerve impulses. The semicircular canals and vestibular sacs mediate balance, and the tympanic cavity is the middle ear space.

Question 17Anatomy and Physiology of the Speech, Language, and Hearing Systems

Tonotopic organization along the basilar membrane means that which property of sound is represented by place?

  1. Duration
  2. Frequency Correct answer.
  3. Loudness
  4. Phase

Explanation

High frequencies maximally displace the basilar membrane near its base and low frequencies near its apex, so pitch is encoded by the location of maximal vibration. Loudness is coded mainly by firing rate and hair cell recruitment, duration by temporal patterns, and phase by timing of neural discharges.

Question 18Anatomy and Physiology of the Speech, Language, and Hearing Systems

The stapedius reflex protects the inner ear by contracting in response to loud sound and thereby doing what?

  1. Increasing the stiffness of the tympanic membrane
  2. Reducing movement of the ossicular chain Correct answer.
  3. Opening the eustachian tube
  4. Widening the external auditory canal

Explanation

Contraction of the stapedius stiffens the ossicular chain and reduces the amount of energy transmitted to the oval window. This dampens loud sounds and is used clinically to assess the acoustic reflex pathway. It does not change the ear canal, directly stiffen the eardrum, or open the eustachian tube.

Question 19Anatomy and Physiology of the Speech, Language, and Hearing Systems

The primary auditory cortex is located in which region of the brain?

  1. The superior temporal gyrus of the temporal lobe Correct answer.
  2. The precentral gyrus of the frontal lobe
  3. The postcentral gyrus of the parietal lobe
  4. The calcarine fissure of the occipital lobe

Explanation

Primary auditory cortex lies in Heschl's gyrus on the superior surface of the temporal lobe, receiving projections from the medial geniculate body. It is tonotopically organized for sound analysis. The postcentral and precentral gyri are somatosensory and motor, and the calcarine fissure is primary visual cortex.

Question 20Anatomy and Physiology of the Speech, Language, and Hearing Systems

During the esophageal phase of swallowing, which event moves the bolus toward the stomach?

  1. Retraction of the tongue
  2. Velopharyngeal closure
  3. Peristaltic contraction of the esophagus Correct answer.
  4. Elevation of the larynx

Explanation

The esophageal phase is driven by sequential peristaltic contractions of the esophageal musculature that propel the bolus to the stomach. Velopharyngeal closure, laryngeal elevation, and tongue retraction belong to the earlier oral and pharyngeal phases.

Question 21Speech, Language, and Communication Development

At approximately what age do most typically developing children say their first recognizable word?

  1. Around 24 months
  2. Around 6 months
  3. Around 12 months Correct answer.
  4. Around 3 months

Explanation

First meaningful words typically emerge near the end of the first year, with a common range of about 10 to 15 months. Earlier vocalizations are cooing and babbling rather than true words.

Question 22Speech, Language, and Communication Development

Canonical babbling, characterized by well-formed repeated syllables such as 'bababa', typically appears at about which age?

  1. 6 to 10 months Correct answer.
  2. 14 to 18 months
  3. 20 to 24 months
  4. 1 to 2 months

Explanation

Reduplicated canonical babbling usually emerges between roughly 6 and 10 months and marks a key step toward syllable production. It precedes first words and reflects developing motor coordination for speech.

Question 23Speech, Language, and Communication Development

A child points to a cup and looks at the caregiver to check that the caregiver has noticed the cup. This behavior is best described as:

  1. Protoimperative gesture
  2. Joint attention Correct answer.
  3. Overextension
  4. Echolalia

Explanation

Joint attention involves coordinating attention between an object and a social partner for the purpose of sharing interest. The looking back to check the partner's focus is the defining feature.

Question 24Speech, Language, and Communication Development

Which sequence reflects the typical order of early morphological development in English-speaking children?

  1. Regular plural -s, then present progressive -ing, then prepositions
  2. Present progressive -ing, then regular plural -s, then irregular past forms Correct answer.
  3. Articles, then irregular past forms, then present progressive -ing
  4. Irregular past forms, then present progressive -ing, then articles

Explanation

Brown's morpheme order shows early emergence of -ing and plural -s, with irregular past forms and other later morphemes following. This ordering reflects increasing grammatical complexity and frequency in input.

Question 25Speech, Language, and Communication Development

A 30-month-old says 'foots' instead of 'feet'. This error most directly demonstrates:

  1. A receptive language disorder
  2. Delayed onset of canonical babbling
  3. Overregularization of a morphological rule Correct answer.
  4. A phonological process of final consonant deletion

Explanation

Overregularization occurs when a child applies a regular rule, such as plural -s, to an irregular form. It indicates that the child has extracted the rule rather than merely imitating.

Question 26Speech, Language, and Communication Development

By approximately what age do typically developing children produce two-word combinations such as 'more juice'?

  1. 12 months
  2. 42 months
  3. 30 to 36 months
  4. 18 to 24 months Correct answer.

Explanation

Two-word utterances generally appear between about 18 and 24 months, marking the transition to grammar. Vocabulary size at this point is commonly around 50 words or more.

Question 27Speech, Language, and Communication Development

A child says 'tato' for 'potato' and 'gog' for 'dog'. These productions most clearly reflect which phonological process?

  1. Fronting
  2. Weak syllable deletion Correct answer.
  3. Cluster reduction
  4. Stopping

Explanation

Weak syllable deletion removes an unstressed syllable from a multisyllabic word, as in 'tato' for 'potato'. The 'gog' example is a separate process, but the question focuses on the multisyllabic reduction pattern.

Question 28Speech, Language, and Communication Development

Which of the following best characterizes fast mapping in vocabulary acquisition?

  1. Rapid initial learning of a new word's meaning after brief exposure Correct answer.
  2. Memorizing a word list through repeated drill
  3. Loss of earlier learned words as new ones are added
  4. Applying a known word to an unrelated category

Explanation

Fast mapping refers to the quick, often one-trial formation of a preliminary word-meaning link. It allows children to acquire vocabulary rapidly without explicit instruction.

Question 29Speech, Language, and Communication Development

A 4-year-old uses 'dog' for cows, horses, and sheep. This pattern is best labeled:

  1. Metalinguistic awareness
  2. Overextension Correct answer.
  3. Underextension
  4. Telegraphic speech

Explanation

Overextension is the broad application of a word beyond its conventional category, often based on perceptual similarity. It is common in early lexical development.

Question 30Speech, Language, and Communication Development

Which feature is most characteristic of telegraphic speech?

  1. Repetition of the examiner's last phrase
  2. Complete sentences with correct inflection
  3. Omission of function words with retention of content words Correct answer.
  4. Omission of content words with retention of function words

Explanation

Telegraphic utterances keep the semantically heavy content words and drop grammatical function words and inflections. Examples include 'daddy go car'.

Question 31Speech, Language, and Communication Development

A child who has not produced any canonical babbling by 11 months and shows no response to name is best managed by:

  1. Referral for developmental and hearing evaluation Correct answer.
  2. Waiting until 24 months before any action
  3. Advising the family to reduce screen time only
  4. Reassurance that all children develop at their own pace

Explanation

Absence of canonical babbling at 11 months and failure to respond to name are red flags warranting prompt hearing and developmental assessment. Early identification improves outcomes.

Question 32Speech, Language, and Communication Development

Which of the following is a protoimperative communicative act?

  1. Repeating a syllable heard from a sibling
  2. Pointing to a bird to share interest with a caregiver
  3. Smiling in response to a familiar face
  4. Reaching and vocalizing to get an adult to open a jar Correct answer.

Explanation

Protoimperatives are gestures or vocalizations used to request an object or action from another person. They serve a regulatory function rather than a sharing function.

Question 33Speech, Language, and Communication Development

Theory of mind development is most closely associated with which later language ability?

  1. Producing accurate consonant clusters
  2. Segmenting words into phonemes
  3. Using irregular past tense forms correctly
  4. Understanding that others can hold beliefs different from one's own Correct answer.

Explanation

Theory of mind involves attributing mental states, including false beliefs, to others. Language supports this understanding, and both develop markedly in the preschool years.

Question 34Speech, Language, and Communication Development

A child's mean length of utterance (MLU) of about 2.5 in morphemes most likely corresponds to which language stage?

  1. Stage I, single words
  2. Stage V, full grammar
  3. Stage II, early word combinations Correct answer.
  4. Stage IV, complex sentences

Explanation

MLU in the range of roughly 2.0 to 2.5 morphemes corresponds to the early multiword period. This is Stage II in Brown's framework.

Question 35Speech, Language, and Communication Development

Which behavior is the most reliable early indicator of intentional communication in an infant?

  1. Startling to a loud sound
  2. Alternating gaze between an object and a person while gesturing Correct answer.
  3. Producing vowel-like cooing sounds
  4. Crying when hungry

Explanation

Intentional communication requires coordinating attention to a partner and a goal, evidenced by gaze alternation with gesture. Reflexive behaviors such as crying do not demonstrate intentionality.

Question 36Speech, Language, and Communication Development

Which statement best describes the role of child-directed speech in language development?

  1. It simplifies and highlights language, and may support attention and word learning Correct answer.
  2. It delays grammatical development by modeling errors
  3. It is used only by caregivers of children with language disorder
  4. It has no measurable relationship with later vocabulary

Explanation

Child-directed speech uses simplified syntax, exaggerated prosody, and salient words that can support attention and early word learning. Its role is facilitative rather than necessary.

Question 37Speech, Language, and Communication Development

By around 5 years of age, a typically developing child's phonological system is best described as:

  1. Mostly intelligible to strangers, with some late sounds still developing Correct answer.
  2. Characterized by consistent deletion of all final consonants
  3. Fully adult-like in all consonant clusters and multisyllabic words
  4. Limited to single syllables with vowel errors

Explanation

Most speech sounds are mastered by about 5 years, though a few later-developing sounds and complex clusters may still be refining. Overall intelligibility to unfamiliar listeners is high.

Question 38Speech, Language, and Communication Development

A child's use of rising intonation to mark a question before producing question words illustrates:

  1. Lexical development
  2. Pragmatic development
  3. Morphological development
  4. Prosodic development Correct answer.

Explanation

Intonation contours are prosodic features, and using them to signal question meaning reflects prosodic development. It precedes and scaffolds later syntactic question forms.

Question 39Speech, Language, and Communication Development

Which conversational skill typically develops earliest in preschool children?

  1. Taking turns in a conversation on a shared topic Correct answer.
  2. Adjusting register for a listener with limited knowledge
  3. Producing extended narratives with a clear climax
  4. Repairing misunderstandings by rephrasing

Explanation

Basic turn-taking emerges early and supports conversational exchange. More advanced skills such as repair, narrative structure, and listener-sensitive register develop later.

Question 40Speech, Language, and Communication Development

A bilingual child is assessed in only one language and scores below monolingual norms on vocabulary. The most defensible interpretation is that:

  1. The child has a language disorder requiring immediate diagnosis
  2. The result may reflect distributed vocabulary across two languages rather than disorder Correct answer.
  3. Vocabulary scores are unaffected by bilingual experience
  4. The child should stop using the home language

Explanation

Bilingual children distribute vocabulary across languages, so single-language testing can underestimate total vocabulary. Assessment should consider both languages and the child's exposure history.

Question 41Speech and Language Disorders in Children

At approximately what age do most children produce their first meaningful word?

  1. Around 30 months
  2. Around 48 months
  3. Around 12 months Correct answer.
  4. Around 3 months

Explanation

First meaningful words typically emerge near the end of the first year, commonly around 12 months, following a period of canonical babbling. Producing no words by 18 months is a recognized red flag for language delay.

Question 42Speech and Language Disorders in Children

A child says "gog" for "dog" and "tat" for "cat". Which phonological process is illustrated?

  1. Cluster reduction
  2. Backing Correct answer.
  3. Stopping
  4. Final consonant deletion

Explanation

Backing replaces an anterior consonant with a posterior one, so alveolar /d/ and /t/ become velar /g/ and /t/. Backing is atypical after about 3 years and is a common target in phonological intervention.

Question 43Speech and Language Disorders in Children

Which feature is most characteristic of childhood apraxia of speech?

  1. Errors limited to written language tasks
  2. Inconsistent errors on consonants and vowels across repeated productions Correct answer.
  3. Consistent substitution of one sound for another
  4. Normal prosody with isolated lisping

Explanation

Childhood apraxia of speech is a motor planning disorder marked by inconsistent error patterns on the same words, vowel distortions, and disrupted prosody. Consistency of errors points instead toward a phonological disorder.

Question 44Speech and Language Disorders in Children

Stuttering in young children most often begins:

  1. Before the first birthday
  2. Between 8 and 10 years of age
  3. Between 2 and 5 years of age Correct answer.
  4. After puberty

Explanation

Developmental stuttering usually emerges between about 2 and 5 years, coinciding with rapid language expansion. Onset in later childhood or adulthood raises suspicion of acquired or neurogenic causes.

Question 45Speech and Language Disorders in Children

A 4-year-old produces "tun" for "sun" and "pish" for "fish". Which process should be the primary intervention target?

  1. Velar fronting
  2. Stopping of fricatives Correct answer.
  3. Gliding of liquids
  4. Weak syllable deletion

Explanation

Replacing fricatives /s/ and /f/ with stops /t/ and /p/ is stopping, which should resolve by about 3 to 3.5 years. Persistence at age 4 makes it a priority target.

Question 46Speech and Language Disorders in Children

Which assessment finding best supports a diagnosis of developmental language disorder rather than a simple delay that will resolve?

  1. Age-appropriate vocabulary with mild articulation errors
  2. Isolated difficulty with one speech sound
  3. Persistent grammatical deficits with average nonverbal cognition Correct answer.
  4. Language scores that improve fully within six months

Explanation

Developmental language disorder is characterized by persistent language difficulties, especially grammar, in the presence of typical nonverbal ability. Persistence and grammatical weakness distinguish it from transient delay.

Question 47Speech and Language Disorders in Children

The typical order of consonant acquisition begins with which class of sounds?

  1. Only consonant clusters
  2. Liquids and glides
  3. Fricatives and affricates
  4. Nasals and stops Correct answer.

Explanation

Nasals and stops such as /m/, /b/, /p/, /n/ are acquired earliest because they are visually salient and motorically simple. Fricatives, affricates, and liquids develop later.

Question 48Speech and Language Disorders in Children

A child with a repaired cleft palate shows hypernasality and nasal air emission. Which mechanism best explains this?

  1. Reduced tongue strength
  2. Hearing loss
  3. Poor phonological awareness
  4. Inadequate velopharyngeal closure Correct answer.

Explanation

Hypernasality and nasal air emission result from incomplete velopharyngeal closure, allowing air into the nasal cavity during oral sounds. Management may involve surgery, prosthetics, or resonance therapy.

Question 49Speech and Language Disorders in Children

Which is a core diagnostic criterion for autism spectrum disorder relevant to speech-language assessment?

  1. Below-average nonverbal IQ
  2. Absence of any spoken words
  3. Persistent deficits in social communication and social interaction Correct answer.
  4. Delayed motor milestones only

Explanation

Autism spectrum disorder is defined by persistent deficits in social communication and interaction plus restricted, repetitive behaviors. Language level alone, including presence of speech, does not define the disorder.

Question 50Speech and Language Disorders in Children

A bilingual child is referred for suspected language impairment. Which approach gives the most valid picture?

  1. Testing only in the school language
  2. Relying on teacher report alone
  3. Testing only in the home language
  4. Assessing both languages with support from an interpreter Correct answer.

Explanation

Valid assessment of bilingual children requires sampling both languages, ideally with a trained interpreter, because a disorder must be evident across languages. Testing one language alone risks misidentifying typical second-language learning as impairment.